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Individual

DUSTIN PATRICK RENFRO

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
CRNA

Contact information

Practice address
1120 S UTICA AVE, TULSA, OK 74104-4012
(918) 579-1000
Mailing address
11130 S 109TH EAST AVE, BIXBY, OK 74008-2624
(918) 381-1193

Taxonomy

Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
108890
OK

Other

Enumeration date
09/07/2017
Last updated
09/07/2017
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